An update from the CEO at the Royal College of Veterinary Surgeons

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In a previous blog I stated that, while the Brexit process may throw up plenty of challenges for the next two years and beyond, there will also be plenty of opportunities to forge closer links with countries that we, perhaps, have ignored over the years in favour of our nearer neighbours.

One of these countries is India where I, along with the President Chris Tufnell, recently embarked upon a fact-finding mission to better understand their veterinary industry and regulatory system, visiting the various veterinary bodies in Delhi including the Veterinary Council of India and a vet school in Chennai.

It is a pretty well-known fact that India is on track to becoming the world’s most populous country by 2030, but it also has one of the biggest ‘veterinary populations’ in the world (not to mention the largest cow population!) with some 90,000 names on the Veterinary Council of India’s Register as well as 44 vet schools. As we look to expand the ‘global brand’ of the RCVS, therefore, India must be one of our key targets – not only because of the size of population but also its long-standing historical ties to the UK.

Chris and I flew first to Chennai (formerly Madras) in the south of the country where we visited the Tamil Nadu Veterinary and Animal Sciences University, meeting Vice-Chancellor and heads of departments to get a sense of how veterinary education works in India. As in the UK the degree courses are longer than most others with five-and-a-half years of education and training – many of them focused on regional agricultural species.

Over the course of 2017 we will be looking to better understand…how we can develop a framework for a pilot project around accreditation of Indian vet schools.

We then travelled to Delhi where we met with the Veterinary Council of India, the Indian Council of Agricultural Research, the veterinary department of Jawaharlal University and the President of SAPAC (the equivalent of the BSAVA) as well as the British Council and British High Commission.

While it was something of a whirlwind tour there were two overwhelming impressions that Chris and I came away with from our discussions with key people and our own observations. The first is that, understandably, veterinary medicine is still very focused on agriculture – but that, with the burgeoning middle class, there is an ever-increasing demand for companion animal-focused vets. The second is that it seems to be a slightly lower status profession in India than the UK but that, like here, it is highly trusted by the public.

In terms of what we want to do in India, we will be looking to build on the links forged during our visit and, over time, possibly look to the country as a potential source of veterinary graduates, as the medical profession does in this country. There are also opportunities for UK students and graduates and for the sharing of knowledge and best practice.

Although some preparatory work has been done, building these links will not be without challenges – the regulatory system is quite different from ours. For example, registration and professional conduct issues are handled by the state branches of the Veterinary Council of India with only educational standards falling under the remit of the central body. As would also be expected of a country of more than one billion people with 29 states, there is also a dizzying array of agencies and organisations and stakeholders so it is difficult to know who to talk to about what.

Over the course of 2017 we will be looking to better understand where the power lies and how we can develop a framework for a pilot project around accreditation of Indian vet schools. This will involve making contact with those key stakeholders – a task that the British Council in India has kindly offered to help us with.

So – we look forward to seeing how this will develop over the coming years and updating you in due course!

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While we are told on an almost daily basis that ‘Brexit means Brexit’ (whatever that may mean!), there is still a very strong case in the veterinary sphere for close cooperation and partnership with our European neighbours.

It is in this capacity that, twice per year, key members of RCVS Council and me attend meetings of the Federation of Veterinarians of Europe (FVE), an organisation that strives to promote animal health, welfare and public health across Europe through spreading knowledge and best practice amongst colleagues across the continent.

One concrete example of how best practice is shared and diffused amongst FVE’s 38 members is the fact that the Vet Futures project, started here in the UK in 2014 as a joint venture between the College and the British Veterinary Association to help the profession determine and prepare for its long-term future, has inspired a ‘Vet Futures Europe’ project.

Key members of RCVS Council and CEO Nick Stace attending a meeting of the Federation of Veterinarians of Europe (FVE) in Brussels, June 2016.

The project aims to develop themes and actions which will help the European veterinary profession plan for its future, and inform a strategic plan for the FVE, as well as providing a framework for other member states to develop national Vet Futures reports. The fact that the project has been so well received by our European colleagues and taken on board by them is very gratifying and demonstrates that Britain is often at the forefront of innovation in the veterinary sphere.

One of the countries that has shown the most enthusiasm for Vet Futures is Switzerland which, while not a member of the EU, is certainly a key player in FVE. It is important to note that FVE is not an EU institution and that many non-EU members are active within FVE, including Norway and Turkey. When the United Kingdom leaves the EU we will continue to have a vital role in FVE as one of the biggest economies in Europe employing many thousands of vets from across the continent.

Leaving the EU may create certain complications – decisions made by the European Parliament regarding animal health and welfare in its member states may continue to have an impact on the UK, yet we will lack the ability to directly influence them. Nevertheless, through FVE, we will still play a big role in lobbying not only the EU but also national governments, institutions, NGOs and other stakeholders in promoting the views of the profession as well as animal health and welfare and public health.

And on the subject of what Brexit might mean for the veterinary profession, we recently had the second meeting of the RCVS Presidential Taskforce on Brexit, where we looked at issues ranging from the labour market to mutual recognition of qualifications and much more. The next meeting will be on 9 November and we will be reporting back to RCVS Council in March 2017 with recommendations.

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While the past few weeks have been very interesting for observers of politics (and great for political journalists!) I imagine that for many veterinary surgeons, veterinary nurses and veterinary practices the excitement may be mixed with a fair bit of uncertainty.

Some 27 per cent of those on the Register of Veterinary Surgeons are registrants from elsewhere in the European Union and they make up around half of all new registrants every year. Meat hygiene and public health are heavily dependent on veterinary surgeons from the EU and I am sure that most veterinary surgeons and veterinary nurses will have colleagues from one of the other 27 states. The input of these vets has been invaluable and I would like to both recognise and applaud the positive impact they have had on the veterinary industry and animal welfare.

The Brexit negotiations have yet to begin and while we may want to give absolute certainties to our EU colleagues that they will continue to be able to live and work here unimpeded – it is very much dependent on the agreements the Government makes regarding freedom of movement and the single market. What we can guarantee, however, is two things. First, that their status as Member of the RCVS is sacrosanct and that, as long as the annual fees are paid, any current registrant will be able to remain on the Register of Veterinary Surgeons.

Second that along with the British Veterinary Association, we will be lobbying and working with Whitehall’s Brexit team and the Department for Environment, Food & Rural Affairs to ensure the transition is as smooth as possible and to take into account the best interests of the veterinary professions and the public. I would personally like to congratulate Andrea Leadsom on her appointment as Secretary of State and look forward to working with her and her team in the coming months and years.

To this end we have set up a Presidential Taskforce to consider the impact of Brexit and which aims to report its conclusions to Council by March 2017. The Taskforce will have several objectives including:

Considering the EU regulations that currently impact on our regulatory responsibilities and make recommendations as to which should be maintained.

Looking at the issue of the mutual recognition of veterinary graduates in Europe and make recommendations for how we might deal with applications to join the Register from EU countries post-Brexit.

Considering manpower requirements and the implications for new systems of immigration.

Understanding how Brexit might impact our current priorities such as governance and the review of Schedule 3.

Considering our role as an accreditation organisation and how we can contribute to and influence international affairs outside the EU.

Studying the financial impact of Brexit on the College.

‘change might not always be comfortable or easy, but we cannot resist it and we need to embrace it..’ (RCVS Day 2016)

Brexit is very much a fact of life now and while some may be disappointed with the outcome of the Referendum, the Taskforce will very much be concerned with scoping out new opportunities and engaging with the way the world is changing. As I said at my recent speech at RCVS Day 2016 in respect of digital disruption – change might not always be comfortable or easy, but we cannot resist it and we need to embrace it, work out what it means and take advantage and control of the situation.

There will be many interesting and tough discussions over the coming months and years – and that will just be in our Presidential Taskforce – but we will continue to keep the profession updated on our progress and how the negotiations may affect EU-qualified veterinary surgeons.

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In my last blog, I mentioned some correspondence from a veterinary surgeon, published in the Veterinary Record, which was so ‘on message’ that, to the cynical eye, it might have looked like we wrote it ourselves!

In fact, it was a totally unprompted and heartfelt letter from a member of the profession about his positive experiences with our concerns investigation process and alternative dispute resolution (ADR) trial.

John Dinsdale, the author, described a concern that had been raised about the conduct of one of his veterinary surgeons who, after a thorough investigation of the circumstances by our Professional Conduct Department, was found to have no arguable case for professional misconduct against her.

However, the client was not satisfied, and the case was referred to our ADR trial, which is independently delivered by Ombudsman Services, and aims to resolve concerns which we cannot deal with ourselves, through conciliation.

To paraphrase the letter, Mr Dinsdale wrote that there was ample communication throughout the ADR process, including regular updates directly to the vet, and that the whole process was relatively simple and fast. To quote from the letter directly:

“The ombudsman ruled again in her favour. This system, along with the excellent approach taken by the RCVS, definitely reduced the stress and anxiety to a manageable level.”

Engagement with ADR

However, despite the fact that this letter was overwhelmingly positive about the ADR trial, this sentiment hasn’t quite been reflected in the profession’s overall engagement with and take-up of the trial.

It has long been my mantra that what is good for the public is good for the profession and I stand by that.

In fact, statistically-speaking, the take-up has been quite disappointing, which is partly why the trial got off to a slow start and had to be extended by six months. Out of the 343 cases that have been considered since the trial started in November 2014, 173 cases were not referred because the vet did not consent.

There has clearly been some scepticism amongst the profession about the benefits of ADR and at the College we need to think about how we convince people of these. It has long been my mantra that what is good for the public is good for the profession and I stand by that. With many complaints, public and professional interest may seem diametrically opposed, but the results of cases referred to the trial prove this is not the case.

Of the 62 cases for which final decisions have been made, a large proportion found that the veterinary surgeon need take no further action to remedy the situation – essentially an exoneration of their actions. In one case, Ombudsman Services has found in favour of the veterinary surgeon and recommended that the client settle their bill.

It is not about apportioning blame but providing resolution.

Inevitably, in some cases, Ombudsman Services has recommended that the veterinary surgeon make amends to the client. Examples have included offering an apology and making a small goodwill payment; being asked to provide documentation to a client with an overview of clinical actions taken; and providing a post-mortem report to a client in language that was understandable to them and without photographs.

I think that, even where the Ombudsman Services has recommended that amends be made to the client, these shouldn’t be seen as negative decisions against the vet. For a start, they are not binding on either party, but, more importantly, they also provide a means of conciliation between the veterinary surgeon and the client, a way to resolve what could otherwise be a protracted and potentially bitter confrontation. It is not about apportioning blame but providing resolution.

However, I think the most important reason to get behind the ADR trial is reputation. A recent Vet Futures survey, conducted by our project partners the BVA, revealed high levels of trust in the profession. This is very gratifying and is reflected in the relatively low number of complaints made about veterinary surgeons and the fact that very few of these end up in Disciplinary Committee hearings.

Nevertheless, this situation is not a given. Back in 2008, and in relation to the fact that the majority of concerns we receive are closed because they do not meet our threshold for serious professional misconduct, a House of Commons Environment, Food and Rural Affairs Select Committee report stated, that ‘allowing such a large number of complaints each year to be dismissed in this way inevitably harms the reputation of the veterinary profession’.

I do not think this is overstating the case. By engaging with dispute resolution the veterinary profession can prove that it is truly dedicated to animal welfare and client care, and that it is willing to engage with and resolve problems in a constructive way. The alternative could be a gradual erosion of these high levels of public trust in the profession.

In his letter, John Dinsdale summarises this point more authentically than I ever could:

“We are already judged by the… public each and every day of our working lives and there is a public perception that Ombudsman Services are fair and open. This should result in an element of trust and a move away from the misguided feeling that we, as professionals, close ranks.”

Next steps

Despite the slow start, the trial is almost two-thirds complete and is set to meet its target of 100 cases by its October deadline. The findings of the trial will be brought to November Council where we will also decide, in the light of our experiences, how we can best implement the EU Directive on ADR.

In the remaining few months it would be great to see some more engagement from the profession in the trial. Greater recognition that an alternative way of solving complaints which we, as the regulator, have no powers to take forward, is vital for maintaining confidence and trust in veterinary surgeons and their art.

If you would like to have a chat with me about the trial, you are very welcome to contact me on nick@rcvs.org.uk. You will find no keener evangelist for ADR than me – excepting John Dinsdale of course!

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The front page of Veterinary Times on 1 June bore the headline ‘Staff back RCVS as great workplace’. This reflected our coming 30th in the top 100 Best Workplace Awards (medium-sized category), run by the Great Place to Work Institute , beating the likes of Coca Cola, Office Angels and General Mills. [See my previous blog for details.]

This was pleasing news in itself, but it was also particularly great to see that headline in print, because one of the exercises carried out back in 2013, as we put together our 2014-16 Strategic Plan, was imagining the headlines we would like to see on the front page of the vet press in three years’ time: the RCVS being a great place to work was one of them.

Clarity of vision

The moral of this story is that when you have a specific goal in mind, and especially when you can articulate and visualise how it might look in print, it has a much greater chance of being met.

This is why our Strategic Plan is full of very specific goals, which were developed out of a process that involved staff, Council and, through the First Rate Regulator Project, the profession and public at large. Some organisations shy away from specific objectives – it’s too easy to be called on them if they are not met. But plans without bite are inevitably left on the shelf to gather dust.

And so I would like to reassure you that, 18 months into our current three-year plan, we have either met, or are on target to meet, the majority of our objectives. The list of actions yet to be tackled is manageable, and one which we may yet add to before 2016 is out.

Complaints progress

But don’t just take my word for it. In addition to the excellent headline in the Veterinary Times, a further testimonial to our hard work could be seen in the Veterinary Record recently (30 May 2015).

Here, veterinary surgeon John Dinsdale was kind enough to praise our Professional Conduct team, specifically highlighting the positive changes that have been made in our concerns-handling process and improvements in communications. This work has been part of our Strategic Plan objective to ‘reduce the time it takes for a complaint to be concluded in a fair and transparent manner’. Mr Dinsdale also commented positively on our trial of an alternative dispute resolution process (ADR), another of our Strategic Plan objectives.

A third piece of recent external validation came in the form of the independent Chair of our Audit and Risk Committee, Liz Butler, giving our current IT projects, which include an upgrade of our database, a new online Practice Standards system and a new IT system for our Professional Conduct work, a clean bill of health.

You can find a full update on our Strategic Plan progress in my CEO Update to Council, available online as part of the June Council paper bundle.

We will soon be starting the process of developing our 2017-19 Strategic Plan, and I will continue to push for sharp, meaningful objectives of the kind that you can sum up in a positive headline. Of course, by being specific you could set yourself up to fail, but it is better to fail to reach a stretching goal than meet a feeble one. Of course, to set yourself stretching goals and meet them is even better!

Finally, following our very successful journey to Edinburgh the other day to hold the first RCVS Council meeting outside London in living memory, here’s a quick video update outlining the main discussions and decisions from the day…

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It’s now the morning after the night before, so I can finally let you in on an exciting secret – something that we at the RCVS have been working towards for quite a while, that I have suspected all along, but that we haven’t been allowed to tell anyone:

The Royal College of Veterinary Surgeons
is a great place to work!

And in case you’re thinking, “Well, he would said that, wouldn’t he?”, you shouldn’t just take my word for it.

In fact, having been presented with 30th place at a special gala evening for the UK’s best workplaces last night, it’s now officially official. But 30th place is a long way from 1st, so we have a lot more to do!

The Great Place to Work (GPtW) Institute is a global research, consulting and training firm that helps organisations identify, create and sustain great workplaces through the development of high-trust workplace cultures. It describes its clients as those organisations that wish to maintain Best Workplace environments, those that are ready to dramatically improve the culture within their workplaces, and those in between the two.

As part of my day-one commitment to make staff engagement a key priority, we have been working with GPtW for the past couple of years, undertaking an annual survey of the whole team to gauge opinions, satisfaction levels and suggestions for improvement. The programme considers areas like teamwork, work environment, innovation, well-being, recognition, organisational culture and how we manage and develop talent. It also enables us to benchmark ourselves against similar-sized organisations, which has the potential for uncomfortable reading from a CEO’s perspective, and leaves little place to hide!

One of my biggest initial challenges was convincing College staff and Council that I was serious about staff engagement; that this was neither a flash in the pan, nor was it going to be easy. And so the early results showed.

An initial staff engagement exercise in autumn 2012, just two months after I started, illustrated that there was much work to do. Morale seemed low, and certain individuals on both the Council and staff were exhibiting poor behaviour that was having a significantly negative effect on the whole team. We took immediate action by outlining the expected new behaviours and attitudes to staff, and instituting a ‘new deal’ with our Council with mutual respect and a ‘one-team’ concept at its heart. A burning platform is often critical for rapid action!

A year later, our first GPtW survey revealed that, on average, 52% of staff felt that the RCVS was a great place to work. This was encouraging, but there was clearly plenty of room for further improvement.

We listened, we acted and we continued to deliver on the promise to make staff engagement our number one priority. We tore up the rule book and asked our staff to write it afresh, making sure that their motivations and their ideas were heard and acted upon. It was staff, aided by managers, who led the turnaround and my job as CEO was to unleash the talent and bring down the barriers preventing positive change.

When we conducted the GPtW survey for a second time, in autumn 2014, the results were remarkable. On average, 91% of the team now felt that Belgravia House was a great place to work, and there were 30-40% improvements across many of the key areas listed above.

Apart from being delighted at this upturn, I was very surprised at just how quickly the transformation had taken place. The GPtW Institute confirmed that there is often a bigger jump in scores in year two, because if improvements continue to be made in all aspects of the workplace, then staff are more inclined to believe change is here to stay.

Our award with today’s Guardian supplement – possibly the first time we’ve been called this since 1844

Now, before anyone might be tempted to accuse us of self-congratulatory back-slapping, I consider the whole process to be one of enlightened self interest. Simply put, a highly motivated and energised workforce, focused on doing its best, will improve the quality of our service to the public and the veterinary profession.

There is now a definite buzz about the place, and people are receptive to new ideas and ways of doing things. This has allowed us to set out an ambitious programme of change and reform so that we can become a truly first-rate regulator. We feel more confident, not only at an organisational level, but also on an individual basis in terms of showing initiative and going that extra mile. This has been reinforced by the incredibly positive feedback we have had from the public and the veterinary profession.

To illustrate this, I’ll finish with a quick story…

A little while ago I was contacted by a friend and founder of a great leadership company called Wavelength, to help a senior director at Apple in Silicon Valley to find a family with whom she was a nanny for some 30 years ago. The link to me was that the father of the child she looked after was a vet.

I forwarded the email to our registration team, who managed to locate the wife of the vet, the obituary of the now deceased vet and the location of the son. What’s more, the team then spent time on the phone with the wife of the vet and, as a result, the family and the former nanny have now spent many hours on skype and email, reunited.

The Apple director could not believe we would go to such lengths to help her and said to me that Apple had a thing or two to learn from us about being a great place to work. I should add, that this all happened during one of our busiest weeks of the registration year.

Above all, it is this human touch, going beyond what is expected of us, that makes the RCVS a great place to work. I don’t profess to be particularly religious but I was lucky enough many years ago to meet Mother Teresa in Calcutta and she once said (not to me though!) ‘be faithful in small things because it is in them that your strength lies.’

It is in these small non-scripted acts where we see the strength of our culture.

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One of the many traditions that abound around this time of year, amidst the carol-singing, over-indulging, panic buying and, in our house, the magic of Father Christmas, the notes up the chimney and the excitement of young children – is the tendency to cast an eye back over the last 12 months and to wonder what the next 12 might have in store.

Now, whilst I would generally consider myself more of a reformer than a traditionalist, this is one tradition that I don’t mind participating in. As the old adage says, in order to know where you’re going, you must know where you’ve been.

In order to know where you’re going, you must know where you’ve been

So what have been some of the key issues and achievements for the College in 2014, and how might these shape our activities in 2015 and beyond?

Listening

As you may well have read on these pages before, a key objective of mine when joining the RCVS as CEO was to truly listen to what our many stakeholders – be they vets, vet nurses, students or members of the public – had to tell us. In 2014 especially, there have been some good examples of where I think we got this right.

Our new guidance on 24/7 emergency veterinary cover – a previously contentious and difficult subject to get right – has been generally well received. This was in no small part due to the comprehensive consultation exercise we undertook in the first part of the year, where we not only called for comments in the normal way, but for the first time also held in-depth ‘Select Committee’- style hearings with many of the key representatives of the vet/VN professions and animal-owning public to identify the real issues and key challenges people were facing.

A 2012 resolution by RCVS Council to remove postnominals from display in the RCVS Register of Members turned out to be an unpopular one. Such was the profession’s unhappiness, in fact, that Council agreed to reverse this decision in June, and then work towards a solution that was acceptable to all. We reported on the new changes in November, which should be rolled out next spring.

Technology provides us with ever-increasing ways to listen to others’ views and gauge opinions, whether that’s through email, online surveys or social media. However, this shouldn’t be at the expense of personal communications – also known as conversations! – whether that’s via formal evidence-gathering sessions like we conducted for the 24/7 review, or, more anecdotally, by getting out and about and meeting people, which I remain committed to doing. I’d like us to continue using all methods at our disposal, whenever we need to consult.

Reform and modernisation

As I said, I’m more of a reformer than a traditionalist, and ensuring that the College is well placed to face the future has been, and will continue to be, a key focus.

Early in 2015 we will have a new Royal Charter – the first in almost half a century – which formally sets out the objects of the College to set, uphold and advance veterinary standards. Perhaps most significantly, the Charter also modernises various regulatory functions, in particular by underpinning the regulation of veterinary nurses and properly recognising them as true professionals in their own right.

In other potentially seismic changes, we are tackling the difficult subject of governance reform, particularly the future function, size and composition of RCVS Council, as well as the structure and membership of our Committees. Council’s discussions in November indicated an appetite for reform, which is hugely encouraging, but there is still more work to do before we reach agreement on what represents the best model for the College to adopt for the future.

Looking ahead

Of course, it’s not just the College’s future that we need to plan for, but that of the whole veterinary profession. To this end, there are now three forward-looking projects underway that should help us do just that.

Together with the British Veterinary Association, we launched the Vet Futures project in November – a major initiative that aims to help the profession prepare for and shape its own future, whilst keeping animal health and welfare at its heart. You can read more about this project on the Vet Futures website, and I would encourage you to join in the monthly debates.

I’m also keen to encourage participation in a trial that could mark a sea change in how the College handles a lot of the concerns raised with us by animal owners. On the basis of what’s good for the consumer can be good for the profession, we’re currently testing alternative dispute resolution as a first step towards settling disputes between users of veterinary services and members of the profession. I would hope the profession recognises the benefits of this trial in helping to resolve long-standing disputes, and would strongly urge members to take part in it, should the opportunity arise.

And then there’s the Mind Matters Initiative, launched in December, which aims to help address the mental health and wellbeing issues that sadly have become such a significant issue for the veterinary profession. A first, very practical, action has been to provide extra funding to the Vet Helpline (0303 040 2551) to enable this confidential support service to be staffed by people, rather than callers having to leave a message and be called back. A vital difference, perhaps, and especially at this time of year.

Thank you

Of course, little, if any, of all these activities would be possible without the tremendous hard work of my colleagues at Belgravia House, and the support and commitment from members of both the RCVS and VN Councils. Their willingness to put the hours in, embrace change, and recognise the benefits that change can bring, has been as inspiring as it’s been encouraging.

My sincere thanks to them and my best wishes to you and yours both this Christmas and for whatever the New Year may bring.